Integrative Surgical Simulation: Comparative Assessment of the Veterinary Assessment Laparoscopic Skills (VALS) and Fundamentals of Laparoscopic Surgery (FLS)

Background: This study examined whether the Fundamentals of Laparoscopic Surgery (FLS) and Veterinary Assessment of Laparoscopic Skills (VALS) simulators produce equivalent learning outcomes and physiological responses in novice participants. Methods: Using a counterbalanced crossover design (n = 17), participants completed the peg transfer task on both simulators while seven data modalities were simultaneously collected: task duration, galvanic skin response (GSR), facial expression analysis (FEA), electroencephalography (EEG), electromyography (EMG), eye tracking, and NASA Task Load Index (NASA-TLX) subjective workload ratings. Results: Findings revealed no significant differences between FLS and VALS on any modality tested. Significant order effects emerged for task duration ( p = 0.017 , d = 1.22) and GSR conductance (adjusted p = 0.005 ), with the first-performed task consistently requiring longer completion times and eliciting higher autonomic arousal than the second, regardless of simulator identity. Conclusions: These findings indicate that laparoscopic skill transfer is not domain-dependent and that FLS and VALS are physiologically and emotionally equivalent training platforms. The results support expanding VALS into veterinary training curricula and underscore the value of multimodal physiological measurement for characterizing within-session learning dynamics in simulation research. Application: Institutions with existing FLS infrastructure can extend laparoscopic training to veterinary students and practicing veterinarians using the same hardware and proficiency-based benchmarks, and shared FLS–VALS curricular pathways may help address the rural shortage of laparoscopically trained veterinary surgeons.